HIV Counseling & Testing in the Workplace: An Innovative Partnership Brings Quality Services to South Africans

November 15, 2012

More than 60,000 South Africans have received HIV counseling and testing services at their workplaces through an innovative partnership supported by Jhpiego, the U.S. Government and South African officials to provide timely access to lifesaving HIV services.

The Siyazi Project worked in partnership with public and private employers, including Ford Motor Company and the Solidarity Center, to provide on-the-job, confidential HIV testing services for workers and their families, as well as screening for TB and other health concerns and integrate these services into wellness programs. Their goal was to provide early diagnosis and referral to HIV services in a key battleground of the sub-Saharan pandemic. An estimated 5.4 million people in South Africa are living with HIV, more than any other country in the world.

Siyazi means “to know” in isiZulu, and the project aspired to empower individuals to take control of their health.

“HIV counseling and testing (in the workplace) has become much more acceptable to South Africans since the project began in 2007,” said Ida Asia, Jhpiego South Africa Country Director. Jhpiego has been working in the country for more than 15 years in collaboration with the government to prevent the needless deaths of women and families through programs in reproductive health, HIV/AIDS and cervical cancer prevention.

Through innovative approaches, Siyazi encouraged companies to include HIV counseling and testing as part of employee wellness programs. Such investments would enhance employee productivity and welfare and bring long-term dividends for employers as a result. The Siyazi team included Kathy Dennill (Siyazi Program Director), Vusi Mahlangu (Siyazi Program Officer), Melusi Ndhlalambi (Chief of Party), and John Kigozi (Monitoring and Evaluation Officer).

With funding from the U.S. Centers for Disease Control and Prevention (CDC), the Siyazi Project established counseling and testing sites in 135 workplaces, ranging from factories and government offices to shopping malls and taxi stands. By working with unions, employees and company officials, the project sought to reduce the stigma of HIV on the job and in their respective communities and create an atmosphere in which knowing one’s status was encouraged. The appeal to workers was “test, know, plan your life.” With knowledge comes power and the ability to live safely and healthy.

Siyazi Project leaders developed a network of more than 600 trained peer educators, counselors and health care providers who administered rapid HIV testing, counseled clients, screened them for TB and other health conditions and connected them with additional health services. This was part of the Jhpiego capacity-building effort to give peer educators the skills needed to provide high-quality services. These same peer educators became lay counselors and ultimately wellness champions.

When a client tested positive, peer educators linked them to HIV care, treatment and post-testing follow-up. Through this unique collaboration of workforce partners, more than 3,000 South Africans who tested positive for HIV were linked to care.

“What has happened through the Siyazi Project has really made a huge dent in many companies who otherwise would not have the opportunity to help their employees have a normal life,” said Buyi Hlabano, of the South African Business Coalition on HIV/AIDS.

The project has led the efforts to establish support groups in workplaces by building the capacity of companies to provide this ongoing support, a critical component of ensuring people remain on treatment and engaged in care.

The idea of an HIV support group appealed to Annelie Scholtz, a representative from the Ford Motor Company, but there was little workplace experience to draw from. The Siyazi Project and a Jhpiego-supported counselor helped Ford establish such a program at their work site. That was just one of the many benefits the company experienced from participating in Siyazi, she said.

“Each and every person on site gets introduced to HIV in the wellness program … while they are there, they are serviced,” she explained. “Our managers on a yearly basis were trained specifically on the impact on return on investments and how to manage our employees.”

As a result, Ford managers are able to support their employees in such a way to reduce disciplinary issues, she said.

There is still a need to integrate services in the workplace so that employees can easily access the health services they need, said Thato Farirai, the CDC representative on the project.

“We can test as many people as possible … but high numbers are meaningless unless we link those to care and treatment services … and I am happy to announce that Jhpiego did exactly that,” Farirai said.

The Siyazi Project was an ambitious step in changing attitudes about workplace HIV prevention and care programs and expanding access to quality services for South Africans. Percy Nhlapo, a Deputy Director at Solidarity Center, looks forward to building on the success of this project. “South Africa has about 40 million people,” he said. “There are a lot of people that still need to be reached out there.”